CTICasesRaging Pulmonary and Extrapulmonary Tuberculosis
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Imaging findings
Chest CT revealed a phenomenal amount of cavitary disease, nodules tracking airways, bronchiectasis, large collections in the left base, and tree-in-bud opacities. Abdominal imaging showed smudgy fat consistent with dry peritonitis and significant wasting with a scaphoid abdomen. A pericardial effusion was also noted.
Key takeaways
This is a severe, raging case of 4+ MTB pulmonary tuberculosis, manifesting with extensive cavitary lung disease. The patient also presented with significant extrapulmonary involvement, including tuberculous pericarditis (pericardial effusion) and dry tuberculous peritonitis, as well as profound wasting ('consumption'). The presentation was somewhat unexpected given the patient's lack of typical risk factors, emphasizing that tuberculosis can appear 'out of the blue' with varied clinical features.
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